哮喘联盟

   摘要
   目的:为确定焦虑与抑郁是否与哮喘中更重的呼吸不适相关。
   方法:患有哮喘的成人(n = 230)经受乙酰甲胆碱激发 (Mch)。焦虑和抑郁，哮喘控制，生活质量在研究条目中分别采用医院焦虑抑郁量表，哮喘控制测试，和哮喘生活质量调查问卷评估。在 Mch 激发前后分别评价呼吸急促的定性描述，呼吸困难强度(校正的Borg 指数和视觉模拟量表[VAS]), 以及其他呼吸系统症状。
   结果:患者根据医院焦虑和抑郁量表分为既不焦虑也不抑郁(NAD)，只焦虑，只抑郁(D),或既焦虑又抑郁(AD)四类。哮喘控制测试和哮喘生活质量得分在AD组最低(均为p < 0.001). Mch激发前呼吸困难和喘息的VAS 得分在AD组最高 (均为 p < 0.05)。在Mch激发后校正的Borg得分上升在AD组(平均 [标准差] 2.5 ± 2.0) 比NAD 组(1.5 ± 1.5)及D 组(0.8 ± 0.9)更高(p = 0.006 和 p = 0.003，分别)。大多数呼吸急促的描述在只焦虑组，D组和AD组比NAD组更流行。多变量logistic 回归模型表明焦虑增加了呼吸困难的风险(Borg得分 OR 1.10, p < 0.001 ; VAS得分的OR为 3.84, p = 0.032 ) 但没有影响其他呼吸系统症状。
   结论:焦虑而非抑郁与更严重的感觉呼吸障碍强度相关，但是与哮喘患者的其他呼吸不适不相关。在给定的呼吸负荷，焦虑可能影响呼吸困难的质量和强度。
 

（杨冬 审校）
Allergy Asthma Proc. 2015 Nov;36(6):447-57. doi: 10.2500/aap.2015.36.3897.

 

Anxiety but not depression symptoms are associated with greater perceived dyspnea in asthma during bronchoconstriction.
 

Li HL1, He XL, Liang BM, Zhang HP, Wang Y, Wang G.
 

Abstract
OBJECTIVE:To determine whether anxiety and depression are associated with greater respiratory discomfort in asthma.
METHODS:Adults with asthma (n = 230) underwent methacholine (Mch) challenge. Anxiety and depression,asthma control, and quality of life were evaluated at study entry by using the Hospital Anxiety and Depression Scale, Asthma Control Test, and Asthma Quality of Life Questionnaire, respectively. Qualitative descriptors of breathlessness, dyspnea intensity (modified Borg scale and visual analog scale [VAS]), and other respiratory symptoms were evaluated before and after Mch challenge.
RESULTS:Patients were classified as neither anxiety nor depression (NAD), anxiety only, depression only (D), or both anxiety and depression (AD) according to the Hospital Anxiety and Depression Scale score.Asthma Control Test and Asthma Control Test, and Asthma Quality of Life Questionnaire scores were lowest in the AD group (both p < 0.001). VAS scores for dyspnea and wheezing before Mch challenge were highest in the AD group (both p < 0.05). The increase in the modified Borg scale score after Mch challenge was higher in the AD group (mean [standard deviation] 2.5 ± 2.0) than in the NAD (1.5 ± 1.5) and D (0.8 ± 0.9) groups (p = 0.006 and p = 0.003, respectively). Most descriptors of breathlessness were more prevalent in the anxiety only, D, and AD groups than in the NAD group. Multivariable logistic regression models indicated that anxiety increased the risk of dyspnea (odds ratio 1.10, p < 0.001 for the Borg score; odds ratio 3.84, p = 0.032 for the VAS score) but not for other respiratory symptoms.
CONCLUSIONS:Anxiety but not depression was associated with greater perceived dyspnea intensity but not other measures of respiratory discomfort in individuals with asthma. Anxiety may shape the quality and intensity of dyspnea at a given respiratory load.
 

Allergy Asthma Proc. 2015 Nov;36(6):447-57. doi: 10.2500/aap.2015.36.3897.